Amazonian scorpions and scorpionism: integrating toxinological, clinical, and phylogenetic data to combat a human health crisis in the world's most diverse rainfores

Venom from Amazonian scorpions of the genus Tityus contains components capable of eliciting a distinct clinical, mostly neurological, syndrome. This contrasts with the mainly autonomic manifestations produced after envenomation by congeneric southern and northern South American species. Herein, we summarize Pan-Amazonian scorpionism by synthesizing available toxinological, clinical, and molecular data gathered from all affected areas in Amazonia, including Brazil, Ecuador, Colombia, Peru, Venezuela, and French Guiana. We searched multiple databases, as well as our own records, for reports of scorpion envenomations in Amazonia by confirmed Tityus spp., and compared the clinical manifestations. To help uncover clinical and venom relationships among problematic species, we explored phylogenetic relationships with a rate-calibrated analysis of mitochondrial COI data from available species. The possible existence of diversity gradients for venom toxic and immunogenic components despite the predicted strong phylogenetic association among species is underscored by discussed clinical and toxinological findings. A multicentric effort, involving all nations affected by this neglected disease, is urgently needed to offer alternatives for treating and understanding this pathology, including the preparation of neutralizing antibodies with a broad range of efficacy.(AU)

Amazonian scorpions and scorpionism: integrating toxinological, clinical, and phylogenetic data to combat a human health crisis in the worlds most diverse rainfores

Abstract Venom from Amazonian scorpions of the genus Tityus contains components capable of eliciting a distinct clinical, mostly neurological, syndrome. This contrasts with the mainly autonomic manifestations produced after envenomation by congeneric southern and northern South American species. Herein, we summarize Pan-Amazonian scorpionism by synthesizing available toxinological, clinical, and molecular data gathered from all affected areas in Amazonia, including Brazil, Ecuador, Colombia, Peru, Venezuela, and French Guiana. We searched multiple databases, as well as our own records, for reports of scorpion envenomations in Amazonia by confirmed Tityus spp., and compared the clinical manifestations. To help uncover clinical and venom relationships among problematic species, we explored phylogenetic relationships with a rate-calibrated analysis of mitochondrial COI data from available species. The possible existence of diversity gradients for venom toxic and immunogenic components despite the predicted strong phylogenetic association among species is underscored by discussed clinical and toxinological findings. A multicentric effort, involving all nations affected by this neglected disease, is urgently needed to offer alternatives for treating and understanding this pathology, including the preparation of neutralizing antibodies with a broad range of efficacy.

Clinico-Epidemiological Profile of Scorpion Sting in a Tertiary Care Centre in South Tamil Nadu

Introduction: Venomous scorpion sting is a medicalemergency. The clinical manifestations vary widely betweenthe children and adult group. Current research aimed to studythe epidemiological profile of Scorpion Stings and to study theclinical profile and prevalence of complications of Scorpionstings.Material and methods: 82 cases of Scorpion sting admittedin Toxicology unit of Tirunelveli Medical College werestudied. Detailed history was taken, and a thorough clinicalexamination was done in all patients. All patients were givenPrazosin except in cases with hypotension.Results:Scorpion sting was more common in monsoonfollowed by Summer season. The sting was more prevalent inthe lower limb. Commonest symptom was pain followed bynumbness and tingling. Dyspnea and perspiration were lesscommon. 60.9% had grade1 envenomation followed by 25.7%patients with grade 2 envenomation. Severe envenomationwas less common. Tachycardia was frequently noted (62.2%)whereas only 3 patients developed pulmonary edema. Allpatients recovered well, and there was nil mortality.Conclusion:Prazosin had good outcome in all patients withscorpion sting. The study throws light on the common clinicalfeatures and complications of scorpion sting.

Predictors of Myocardial Dysfunction in Children with Indian Red Scorpion (Mesobuthus tamulus) Sting Envenomation.

Objectives: To identify predictive risk factors for myocardial dysfunction in children with scorpion sting envenomation and to evaluate the effects of Scorpion antivenom and prazosin combination therapy on occurrence of myocardial dysfunction. Design: Observational. Setting: Tertiary care hospital in Southern India. Participants: 85 children aged <13 years with scorpion sting envenomation. Outcome measures: Frequency of myocardial dysfunction; predictors of myocardial dysfunction. Results: 24 children (28.2%) developed myocardial dysfunction. Hypotension at admission (P=0.003) and increased time (>4h) between sting and administration of appropriate therapy (P=0.001) were independent predictors of myocardial dysfunction on logistic regression. Scorpion antivenom plus prazosin combination therapy led to an increase in cumulative proportion of children without myocardial dysfunction. Conclusion: Early (<4 hours) administration of Scorpion antivenom along with prazosin increases the cumulative percentage of children not developing myocardial dysfunction.

Escorpionismo. Registro de consultas médicas en el Centro Nacional de Intoxicaciones: período 2000-2010 / Scorpionism. Registration of medical consultations at the National Poison Center: Period 2000-2010

El escorpionismo es un envenenamiento de etiología accidental producido por la inoculación del veneno de un alacrán o escorpión, que ocurre predominantemente en áreas urbanas, en el ámbito domiciliario o peridomiciliario. En nuestro país son tres las especies de escorpiones de interés médico-sanitario: Tityus trivittatus, T. confluens y T. bahiensis. El cuadro clínico se caracteriza por presentar dolor agudo con escaso compromiso cutáneo y manifestaciones sistémicas que pueden, ocasionalmente, causar la muerte, principalmente en niños. El objetivo de esta publicación es, dar a conocer el registro de consultas en el Centro Nacional de Intoxicaciones en el período comprendido entre Enero de 2000 a Diciembre de 2010.

The scorpionism is an accidental poisoning produced by the inoculation of the venom of a scorpion, which in Argentina occurs predominantly in urban areas, in the domestic environment or around the human habitat. In our country there are three species of scorpions of medical-health concern: Tityus trivittatus, T. confluens and T. bahiensis. The clinical picture is characterized by severe pain with limited cutaneous and systemic manifestations, can occasionally include death, especially in children. The aim of this publication is to present the consultation in the National Poison Center in the period from January 2000 to December 2010.

Escorpionismo: presentación de un posible caso grave ocurrido en la Ciudad Autónoma de Buenos Aires / Scorpionism: presentation of a possible serious case occurred in Ciudad Autónoma de Buenos Aires

El escorpionismo, en su aspecto clínico es un envenenamiento de causa accidental producido por la inoculación del veneno de un alacrán o escorpión, que en Argentina ocurre predominantemente en áreas urbanas, en el ámbito domiciliario o peridomiciliario. En nuestro país son tres las especies de escorpiones de interés médico-sanitario: Tityus (T.) trivittatus, T. confluens y T. bahiensis. El cuadro clínico se caracteriza por presentar dolor agudo con escaso compromiso cutáneo y manifestaciones sistémicas que, sin tratamiento pueden provocar la muerte, principalmente en niños. El objetivo de esta comunicación es dar a conocer el primer caso de escorpionismo grave, ocurrido en la Ciudad Autónoma de Buenos Aires, en una niña de 4 años de edad y describir el cuadro clínico característico y la necesidad del tratamiento precoz en los casos moderados y severos.

Scorpionism in its clinical aspect is an envenoming caused by accidental sting and inoculation of venom from a scorpion, which in Argentina occurs predominantly in urban areas, in the home environment or peridomiciliary. In our country there are three species of scorpions of medical-health concern: Tityus (T.) trivittatus, T. confluens and T. bahiensis. The clinical picture is characterized by severe pain with limited cutaneous and systemic manifestations, that without treatment can cause death, especially in children. The aim of this communication is to present the first case of severe scorpionism occurred in the City of Buenos Aires, in a 4 years old girl, and to describe the characteristic clinical picture and the need for early treatment in moderate and severe cases of scorpionism.